Conventionally, when image diagnosis is made in the medical field, a film image sensed using X-rays is observed while being set on a schaukasten. However, since a normal X-ray film is set to emphasize contrast within the density range from 1.0D to 1.5D that allows easy observation in quest of easy observation of a portion to be diagnosed, if the image sensing condition slightly deviates from an appropriate condition, an image suffers overexposure or underexposure, thus adversely influencing diagnosis based on image reading.
With the advance of computers in recent years, computerization has infiltrated into the medical field. This trend is also rapid in the image diagnostic field, and various CT apparatuses, ultrasonic wave diagnostic apparatuses, diagnostic apparatuses using radioisotope, and the like have prevailed remarkably. A concept called “total image diagnosis” that totally diagnoses various modality images by connecting various diagnostic apparatuses via a computer has been entertained. However, an X-ray film image is essentially an analog image. Hence, although the X-ray film image is most frequently used in image diagnosis and is considered very important, it cannot satisfactorily merge into total image diagnosis, and disturbs computerization of the image diagnosis field.
In recent years, an X-ray image sensing (radiographic) apparatus using a solid-state image sensing element has been developed, and a radiographic apparatus suitable for the aforementioned computerization is beginning to be used for X-ray images (radiographs). When this radiographic apparatus is used, the already radiographed image can undergo contrast adjustment, and since a radiographed image can be obtained in real time, if radiographing operation fails, a re-radiographing operation can be done immediately.
When this apparatus is used, a radiographed image is immediately displayed, and images ordered in a hospital can be efficiently radiographed. Hence, the time required per examination can be relatively shorter than other diagnostic apparatuses such as CT apparatuses, ultrasonic wave diagnostic apparatuses, diagnostic apparatuses using radioisotope, and the like. However, if pre-processes such as input of a patient's name, patient ID, and the like are complicated and time-consuming upon examination, the examination time is prolonged consequently, resulting in poor radiographing efficiency.
In a conventional radiographing operation, X-ray generation conditions suitable for radiographing are manually input to an X-ray generation apparatus while checking an ordered examination sheet. However, when a radiographic apparatus is introduced, the operator must input setups such as radiographing conditions and the like to the X-ray generation apparatus and radiographic apparatus, and must execute image setup processes such as reverse, rotation, and the like of each radiographed image, resulting in poor radiographing efficiency.
To solve this problem, an X-ray examination (radiographing) progress system that links an X-ray examination progress apparatus and a radiographic apparatus is prevalently used. Since the X-ray examination progress system receives order information from an ordering apparatus in a hospital, patient information and radiographing information are correctly sent from the X-ray examination progress apparatus to the radiographic apparatus via this link, and the need for pre-processes such as input of a patient's name, patient ID, and the like, and input and selection of a portion to be radiographed can be obviated.
In a hospital, a doctor often combines a plurality of radiographing operations in one order. Therefore, the ordering apparatus handles orders for each examination. For example, in “chest abdomen examination”, one package of three radiographing operations, i.e., chest front radiographing operation, chest side radiographing operation, and abdomen front radiographing operation is called one examination. Ordered examination information is converted into digital data together with patient information such as a patient ID, patient's name, the presence/absence of pregnancy, and the like, of a patient to be examined, and is sent to the X-ray examination progress apparatus in a radiographing room. Such order information for each examination will be referred to as examination order information hereinafter, and each of one or more pieces of radiographing information contained in the examination order information will be referred to as radiographing order information hereinafter.
However, in some cases, the setups of radiographing operations and acquisition processes of the radiographic apparatus are to be done on the radiographic apparatus side on the basis of the transferred examination order information. Such case will be explained below.
For example, in order to set a minimum required X-ray dose on a patient as well as to satisfactorily print a portion to be radiographed on a film, X-ray aperture value, relative position (an offset value of the X-ray tube central position with respect to the image sensor central position), such as a relative height of an X-ray tube and an image sensor, and X-ray generation condition such as a tube voltage are controlled before a radiographing operation is performed on the basis of information such as an age, weight, height, gender, and the like in the examination order information. Furthermore, after a radiographing operation is performed, control of extracting a radiographed image must be done in accordance with output format information such as division amount of an output image (number of images within an output image), portrait, landscape, and the like, so that an irradiation field portion of a radiograph corresponding to the X-ray aperture appropriately is within a film.
FIGS. 14A and 14B show examples of chest radiographing. In a chest front AP radiographing (radiographing in which X-rays pass through the chest from the abdomen side to the back side) shown in FIG. 14A, a radiographed image can be output as it is. However, in a chest front PA radiographing (radiographing in which X-rays pass through the chest from the back side to the abdomen side) shown in FIG. 14B, a radiographed image must be reversed horizontally upon display. Upon reading an image, a doctor normally observes a film with patient's heart on the right side. For this reason, control such as rotation, reverse, and the like of an image in a direction designated in advance is required in correspondence with a radiographing direction such as AP, PA, or the like of radiographing order information. However, such horizontal reverse is made in accordance with AP/PA only when a specific portion such as a chest is to be radiographed. Upon radiographing other portions such as a head or the like, such process is inhibited.
FIGS. 15A and 15B show examples when a patient's name is superimposed on a radiographed image. When characters are superimposed on an output image, it is a common practice to superimpose the patient's name at the lower central position in a chest front radiographing, as shown in FIG. 15A, and at the upper left position in a chest side radiographing, as shown in FIG. 15B. This is because when a portion to be radiographed is formed on nearly the entire surface of the film, a region which is clinically not important is generally the lower central region in a chest front radiographing, and the upper left region in chest side radiographing. For this reason, a setup process for rendering characters in accordance with character output position information of the radiographing order information is required.
FIGS. 16A to 16D show more complicated examples of the process printing characters on a radiographed image.
When X-rays strike from the back side of the hand upon radiographing the left hand, letter “L” that means the left hand is laid out on the left side (small finger side) of the hand when viewed from the back of the hand, i.e., on the left side of the image, as shown in FIG. 16A. When X-rays strike from the palm side of the left hand, letter “L” that means the left hand is laid out on the left side (small finger side) of the hand when viewed from the back of the hand, i.e., on the right side of the image, as shown in FIG. 16B. Likewise, when X-rays strike from the back side of the hand upon radiographing the right hand, letter “R” that means the right hand is laid out on the right side (small finger side) of the hand when viewed from the back of the hand, i.e., on the right side of the image, as shown in FIG. 16C. When X-rays strike from the palm side of the right hand, letter “R” that means the right hand is laid out on the right side (small finger side) of the hand when viewed from the back of the hand, i.e., on the left side of the image, as shown in FIG. 16D. In this manner, a setup process for rendering characters in accordance with portion information, radiographing direction, right/left information (right-and-left distinction of an organ or portion such as the right and left hands) of the radiographing order information is required.
If a long exposure time is set upon determining the grid moving speed, grid must be moved slowly; if a short exposure time is set, grid must be moved quickly. For example, if the grid stands still without being moved, interference occurs between sensor sampling and the grid, and moiré is generated on the image. If the grid moves slowly even when a short exposure time is set, moiré is generated as in a case wherein the grid stands still. For this reason, a setup process for setting the grid moving speed based on the setup exposure time is required.
Furthermore, when a printer or image storage device as an image transfer destination breaks down and is switched to a backup printer or backup image storage device upon determining image transfer information, the image transfer destination must be designated again in accordance with the examination order information. In this case, if many radiographic apparatuses are used, setups must be changed in those apparatuses, resulting in much extra labor. Since the printer or image storage device may break down unexpectedly, a setup change process of the transfer destinations is required not only for order information, radiographing of which is not started yet, but also for examination, radiographing of which is underway, examination, radiographing of which is complete but information of which is not transferred yet, and examination which is suspended due to a transfer error.
The ordering system preferably integrally manages examination ID values generated by respective radiographic apparatuses in terms of management in an image storage device as an image transfer destination. Such ID values are often important for a matching process if the ordering system of a facility is linked with an image storage system of the facility. However, such values differ depending on facilities, and information provided by the ordering system must be recorded on a header of an image file in a specific description manner upon image transfer.
In all the above examples, examination order information that lacks a parameter of image sensing order information must be processed. More specifically, in some facilities, for example, right/left information may not be sent, and no information of a predetermined parameter may be sent in case of emergency, or information of a predetermined parameter may not be input due to input errors or the like. Furthermore, a setup exposure time may not be determined in advance in a case of radiographing using auto exposure control (AEC), and is not included in the examination order information.